Provider Demographics
NPI:1720250798
Name:JEFFERSON-WOODS, DEBORAH EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:EILEEN
Last Name:JEFFERSON-WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:EILEEN
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:403 S LONG BEACH BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-3449
Mailing Address - Country:US
Mailing Address - Phone:323-774-6551
Mailing Address - Fax:310-763-2315
Practice Address - Street 1:403 S LONG BEACH BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3449
Practice Address - Country:US
Practice Address - Phone:323-774-6551
Practice Address - Fax:310-763-2315
Is Sole Proprietor?:No
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40941208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics